目的:总结60 例胃癌患者术后早期应用三腔喂养管行肠内营养支持的护理体会。方法:所有患者均于术晨放置三腔喂养管,术后早期行肠内营养支持,观察患者胃肠道反应及血清蛋白营养指标变化(白蛋白、前白蛋白、转铁蛋白)。结果:术后1 天患者白蛋白、前白蛋白、转铁蛋白均明显下降,术后10 天营养指标,明显高于术后1 天(P lt;0.05)。结论:胃癌患者术后早期应用三腔喂养管行肠内营养支持可促进胃肠道功能的恢复,减少患者术后并发症,减轻患者经济负担,是一种安全有效的营养支持方法。
Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma (RSCC). Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database, to explore the effect of surgical treatment on cancer-specific survival (CSS) and overall survival (OS). Results A total of 348 cases were included with the median follow-up of 8 months (IQR: 3–16 months). Of the 101 patients in the operation group, 84 died (83.2%), including 56 tumor-related deaths (55.4%). Of the 247 patients in the non-operation group, 215 died (87.0%), including 131 tumor-related deaths (53.0%). The estimated 1-year OS of the operation group and the non-operation group were 49.6% and 34.4%, respectively, and the estimated 1-year CSS of those were 62.2% and 49.2%, respectively. There were significant differences between the two groups (both P<0.05). Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation, SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for OS, and SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for CSS (all P<0.05). The OS [RR=0.61, 95%CI was (0.45, 0.81), P<0.001] and CSS [RR=0.67, 95%CI was (0.47, 0.95), P=0.025] in RSCC patients were significantly improved by surgical treatment. Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.
Objective To evaluate the prognostic value of surgical treatment in gallbladder squamous cell carcinoma (GSCC) by using real-world data with a large sample in the Surveillance, Epidemiology and End Results (SEER) database. Methods The clinical data of patients with pathologically diagnosed GSCC from 2000 to 2019 were extracted from the SEER database. According to the inclusion and exclusion criteria, a total of 257 patients were included after strict screening. The patients were divided into operation group and non-operation group according to whether they underwent surgery. The cancer-specific survival (CSS) and the overall survival (OS) between the two groups were compared, and the influencing factors for the CSS and the OS were analyzed by using Cox proportional hazard model. Results Of 257 patients, 127 (49.4%) were in the operation group, and 130 (50.6%) in the non-operation group. The average follow-up ranged from 0 to 220 months, with the median follow-up time of 3 months. Of the 127 patients in the operation group, 105 died (82.7%), including 88 tumor-related deaths (69.3%). Of the 130 patients in the non-operation group, 124 died (95.4%), including 115 tumor-related deaths (88.5%). The median survival time for OS in the operation group and the non-operation group were 6 months and 3 months, respectively, and that for CSS were 7 months and 3 months, respectively. The estimated 1-year OS of the operation group and the non-operation group were 30.1% and 4.6% respectively; the estimated 1-year CSS were 35.1% and 5.8%, respectively. There were significant differences between the two groups on OS and CSS (χ2=41.400, P<0.001; χ2=42.750, P<0.001). That the OS [HR=0.44, 95%CI (0.25, 0.77), P=0.004] and the CSS [HR=0.46, 95%CI (0.25, 0.84), P=0.011] in GSCC patients were significantly improved by surgical treatment, showed by the results of multivariate prognostic analysis via Cox proportional hazard mode. Conclusions Surgical treatment was an independent factor affecting the prognosis of GSCC, and it could improve the OS and the CSS. As for the modus operandi, R0 resection should be recommended.
【Abstract】Objective To study the clinical application of laparoscopic operation. Methods The clinical findings from 13 840 cases of laparoscopic surgery in this hospital from 1992 to 2005 were reviewed retrospectively.Results Laparoscopic operation were performed successfully in 13 653（98.6%）,187 cases were transferred to open operation. Complications were occurred in 115 cases, including common bile duct injury in 3 cases. Combined treatment with laparoscope and endoscope were performed in 162 cases. Eleven thousand three hundred and fiftytwo patients had been succeeded in followup survey. Over 90.0 percent of patients recovered smoothly. Conclusion Laparoscopic operation may be applied in a more extensive scope. The major complications can be reduced by strict procedures of laparoscopic operation. The combined treatment of laparoscope and endoscope should be further studied and widely used.
ObjectiveTo investigate the impact of surgical treatment on the prognosis of patients with gastric signet-ring cell carcinoma (GSRC). MethodsThe clinicopathologic and prognosis data of patients pathologically diagnosed with GSRC from 2000 to 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The Cox proportional hazards regression model was used to analyze the impact of surgery on overall survival (OS) and cancer-specific survival (CSS) of patients with GSRC. ResultsA total of 3 457 patients with GSRC were included, including 2 048 cases in the operation group and 1 409 cases in the non-operation group. The propensity-score matching by a 1∶1 nearest neighbour algorithm was conducted to control for confounding baseline differences. There were 802 cases in the operation group and 802 cases in the non-operation group after matching. The OS and CSS curves drawn by Kaplan-Meier method of the operation group were better than those of the non-operation group (χ2=434.3 P<0.001; χ2=412.4, P<0.001). The multivariate Cox proportional hazards regression analysis showed that the elderly (≥ 60 years old), late AJCC tumor stage (stage Ⅰ as reference), and patients with bone metastasis of GSRC increased the risk of shortening OS and CSS (P<0.05), while patients treated with surgery and chemotherapy decreased the risk of shortening OS and CSS (P<0.05). ConclusionAccording to the analysis results of SEER database in this study, surgical treatment is beneficial to improve the prognosis for patients with GSRC.
ObjectiveTo analyze the causal relationship between the intake of cheese or tea and the risk of gastroesophageal reflux disease (GERD). MethodsUsing a two-sample Mendelian randomization approach, single nucleotide polymorphisms (SNPs) associated with milk or tea intake were used as instrumental variables. The causal effect of milk or tea intake on the risk of GERD was investigated using the MR Egger method, the weighted median method, the inverse-variance weighted (IVW) random-effects model, and the IVW fixed-effects model. Multivariable analysis was conducted using the MR Egger method, and leave-one-out sensitivity analysis was performed to validate the reliability of the data. ResultsCheese intake could reduce the occurrence of GERD [IVW random-effects model β=–1.010, 95%CI (0.265, 0.502), P<0.05], while tea intake could lead to the occurrence of GERD [IVW random-effects model β=0.288, 95%CI (1.062, 1.673), P<0.05]. ConclusionCheese intake may have a positive causal relationship with reducing the risk of GERD occurrence, while tea intake may have a positive causal relationship with increasing the risk of GERD occurrence.